Florida Deaths Raise Questions About Child Welfare System

This is TELL ME MORE from NPR News. I'm Celeste Headlee, Michel Martin is away. Coming up, we talk with actor Ziyi Zhang about her latest film "The Grandmaster," and women in kung fu. That's in a moment. But we start our program today in Florida. At least 20 children who were on the radar of child protective services have died there since April, that's according to an investigation by the Miami Herald. And the question of course is, why and how do we stop more deaths from occurring?

To help us make sense of it all, we called on Miami Herald reporter Carol Marbin Miller. She's covered child welfare issues for the paper for more than 20 years. And also with us is Linda Spears. She's the vice president for policy and public affairs for the Child Welfare League of America. That's a coalition of hundreds of private and public child welfare agencies. So welcome to you both.

LINDA SPEARS: Hello.

MARBIN MILLER: Thank you.

HEADLEE: Carol, this has been your beat for a long time. I want to start with the story of Jewel Renee Howard. She's a three-year-old who passed away in April, and the medical examiner said her death was the result of homicidal violence. We spoke with her paternal grandmother, Tiffany (ph) Howard. And Tiffany (ph) would watch Jewel during the days, and she'd notice how her granddaughter would cry when her mother came to pick her up.

(SOUNDBITE OF ARCHIVAL RECORDING)

TIFFANY HOWARD: She always cried and screamed at the top of her lungs. She didn't want to go, and it was just terrible. And I'm like, why would she do something wrong? We would say, you're momma come and get you, Jewel, she'll pick you up. And you scream and you yell at the top of your lungs. And I can't understand that to save my own life.

HEADLEE: Listening to the grandmother speak about her granddaughter - and this is a young 3-year old who ended up dying in the emergency room of her injuries. It would be bad enough if this were one child, one case, but 20 children since April - what has it been like for you reporting on this?

MILLER: About two months ago, an infant by the name of Brian Osceola passed away, and that case was every bit as tragic as Jewel's. Brian's mother had been found slumped over in her car, passed out drunk, and Brian was lying on the front seat with his head on her lap. The Department of Children and Families did nothing about that. They decided, for reasons that are unclear to us, that the mother did not have a drinking problem, and they left Brian in place without any services whatsoever to mitigate her drinking problem. In about a month - two months later, the mother left him in the car with her purse and a bottle of beer and went into the house and left him there.

And of course, in Florida, he baked to death. In the ensuing months, we started to look very carefully. As the pattern built, we realized that, beginning with Jewel Howard - which was mid-April - there were at least 20, probably more, kids who were known to the department who subsequently perished. One of the interesting things about Jewel, when you hear the grandmother speak this issue of a little girl being petrified to go with her mother, that's just a horrible red flag.

HEADLEE: Linda, help us to put this into context because, as tragic as it is, children do pass away. I mean, in terms of nationwide - children who are overseen by a state agency, for example, 20 since April - is that a very high amount?

SPEARS: I can tell you that intuitively, to me, the number is high. The child abuse fatality data across the country is not that wonderful. And there are a couple of reasons for it. One is that every state requires different things about how things get counted. There are lots of deaths, which - and I think some of these may fall into that category where on the surface it may have first looked accidental or it may have first looked like a natural causes, and then at greater scrutiny it looks like a child-abuse fatality. Nationwide, they estimate that close to 1,600 children a year die of child abuse and neglect fatalities. It comes two - about two kids for every 100,000 children in the population.

Two out of 100,000 seems very, very small and it's probably - what you would say numbers-wise - is not our worst public health problem, but it is one of our most severe public health problems. So I think whenever you get into a situation where you are concerned about children dying of abuse and neglect and that those abuses and neglected may have happened in a way that indicates that someone could have prevented them, then you've got monster concerns. I think we have two levels of concern. One is the public health concern and two - the ones that we know about, we've got to make sure we're doing a better job of intervening.

HEADLEE: Carol, you've reported on this. And one of the things which has occurred since the Miami Herald began investigating is that the person overseeing all of this has resigned just about a month ago and there is an investigation going on. Where does that investigation stand?

MILLER: I think that investigation is going to require some time to play out. What Florida has done is to launch, some might say, a radical family preservation effort on the cheap. And as a consequence, what Florida Child Welfare investigators and caseworkers are doing is coming upon these very troubled families where children are at risk and in danger. And because there is so little interest in removing them and because there's virtually no ability within the system to intervene meaningfully, we give out brochures for domestic violence shelters, for drug treatment centers, for mental health care, and we say, we invite you to avail yourself of these resources. Now go forth and abuse and neglect no more. And what we're learning is that that just doesn't work because if you are a serious drug fiend, for instance, and your drug use is a danger to your children, simply extracting a promise from you to cease being a drug fiend is not going to work.

HEADLEE: If you're just joining us, we're talking about an alarming number of children who've died in Florida. They were all on the radar of Florida's Child Protective Services. We're joined by Miami Herald reporter Carol Marbin Miller, whom you just heard, and Linda Spears of the Child Welfare League of America. We actually contacted the Florida Department of Children and Families and Interim Secretary Esther Jacobo sent us a statement. She says, quote, there will never be an acceptable number of child deaths. And she goes on to say, I believe we can do better, we must do better and we will do better. In the past, we've seen that knee-jerk reactions to tragedies often add layers of bureaucracy that only mask the true issues and provide the public with a false sense of security. I want to be deliberate in our review of the circumstances surrounding these recent deaths in order to fully understand what went wrong and come out better and stronger on behalf of the vulnerable children who are counting on us. Ms. Jacobo also says the state has called on an outside group to study what's going on in Florida and then recommend some changes. So, Linda, when she talks about these knee-jerk reactions - people obviously want to immediately solve a problem. And she says that trying to fix things quickly can cause more problems than it solves. What do you think of that?

SPEARS: Child Welfare has a history of when there's a crisis - when it's working in one direction and there's a crisis of this pendulum swinging to the other direction - so that we'll do like Florida has done on numerous occasions, which is engage in massive system - systemic reform strategies. Those reform strategies often move the chairs around, but they may not necessarily fundamentally change what happens with front-line caseworkers who are working with families every day to figure out who's safe, who's at risk and what interventions are needed. Often, agencies do what I would call systemic changes, which may well be needed to make sure that there's a level of scrutiny on cases, to make sure that there's sign offs on things. All of those things are absolutely needed. But the fundamentals are about what happens for children every day in their homes. What is it that caseworkers do?

Do they understand the difference between services that reduce risk and services that produce safety? They're related but they're not the same thing. So if you have a family where there's a substance abuse problem, you can easily say, I think this child is safe and I'm going to get mom into substance abuse treatment. And mom may go. And she may have good intentions for a short period of time, but then she falls off. She stops going and engages a new boyfriend in her life who has a history of violence and severe substance abuse. Safety changes, number one - it doesn't stay the same. You got to kind of stay on top of it. And number two, services that mitigate risk don't produce immediate safety.

HEADLEE: Carol, let me bring this back to you because we heard from Jewel's grandmother earlier and I should say that the police say that it was the mother and the boyfriend that actually caused those injuries and caused Jewel's death. And in fact, through your own reporting, most of these injuries and deaths were caused by one or the other of these children's own parents. That makes it problematic when the focus of the state is to keep the kids with their biological parents.

MILLER: I think that you can preserve families in a safe way when the maltreatments that the children are suffering are amenable to treatment. If you have a mother who is very young and lacks judgment, who has a significant drug problem, who may suffer from a serious mental illness such as schizophrenia or bipolar disorder, who has a violent boyfriend in the home and she is more committed to her relationship with the boyfriend than her children, the amount of intervention that it would require to protect that child is enormous. And I would suggest that, in circumstances such as that where the child has already suffered a quantifiable harm - the child's been beaten or severely neglected - you probably do need to remove that child and stabilize the mom before you consider that case safe. Every parent will tell you that they love their children and they wish to do what's best for them.

But we know that drugs and alcohol and mental health issues cloud judgment and make it very difficult to follow through with programs designed to mitigate risk, and I'm not entirely sure why that is. I think part of it has to do with money and I think part of it has to do with the fact that Florida has embraced this model of preserving families. We've embraced it so aggressively that front-line workers and their supervisors and their lawyers now believe that virtually any risk can be mitigated with services - and not necessarily services that they know have been engaged and are succeeding.

HEADLEE: That's Carol Marbin Miller. She's a reporter for the Miami Herald. She's covered child welfare issues for the paper for more than two decades, and she joined us from member station WLRN in Miami. Linda Spears is the vice president for policy and public affairs for the Child Welfare League of America, and she joined me here in Washington. Thanks to both of you.